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The risk factors for thrombosis in children with acute lymphoblastic leukemia

Selda Sivaslioglu1, Turkiz Gursel2, Ulker Kocak2

  • 1Newborn Unit, Ankara Etlik Zübeyde Hanim Women's and Maternal Training and Research Hospital, Ankara, Turkey seldasivaslioglu@gmail.com.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|February 1, 2013
PubMed

Insights

Factor V Leiden mutation significantly increases thrombosis risk in children with acute lymphoblastic leukemia (ALL). Age, catheter use, and prednisolone also contribute to thromboemboli in ALL patients.

Area of Science:

  • Pediatric Hematology
  • Oncology
  • Thrombosis Research

Background:

  • Acute lymphoblastic leukemia (ALL) treatment, particularly the Berlin-Frankfurt-Münster 95 protocol, is associated with an increased risk of thrombosis in children.
  • Identifying specific risk factors is crucial for preventing thromboembolic events during pediatric ALL therapy.

Purpose of the Study:

  • To investigate the risk factors associated with thrombosis in pediatric patients undergoing treatment for ALL using the Berlin-Frankfurt-Münster 95 protocol.

Main Methods:

  • A cohort of 82 children under 16 years old treated with the Berlin-Frankfurt-Münster 95 protocol were followed for 10 years.
  • Genetic analysis was performed to identify mutations such as factor V Leiden (FVL), methylenetetrahydrofolate reductase (MTHFR), and prothrombin (PT) 20210A.
  • Statistical analysis, including odds ratios and confidence intervals, was used to assess the significance of various risk factors.

Main Results:

  • Thrombosis occurred in 12% of patients, primarily after the M protocol phase.
  • Factor V Leiden (FVL) mutation was the most common genetic risk factor (15.6%), significantly increasing thrombosis risk (OR = 7.1).
  • Other identified risk factors included age, catheter usage, and prednisolone treatment.

Conclusions:

  • Factor V Leiden mutation is a significant risk factor for thrombosis in children with ALL treated with the Berlin-Frankfurt-Münster 95 protocol.
  • Age, catheter use, and prednisolone treatment are also important contributors to thromboembolism in this patient population.
  • Further research may focus on targeted prophylactic strategies for high-risk individuals.

Keywords:
clinical thrombophiliathrombophiliathrombosis

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